Professor Clive Hamilton, a commentator on the climate change debate, has taken it upon himself to draw parallels with dissent on vaccination practice in his article “Climate and vaccine deniers are the same: beyond persuasion”, published on the university and CSIRO funded The Conversation website.

The Conversation promises “we only allow authors to write on a subject on which they have proven expertise…” but what expertise does Clive Hamilton have on the subject of vaccination/immunisation?  There is no indication of any expertise in this area in his profile on The Conversation website.

See below my email response to Professor Hamilton, including reference to questionable HPV vaccination.  My email has also been copied to a variety of other parties with an interest in this matter, including Andrew Jaspan, Executive Director and Editor of The Conversation, and Professor Ian Frazer, co-inventor of the technology enabling the HPV vaccines and his colleagues at the Australian Academy of Science.

___________________

From: Elizabeth Hart <eliz.hart25@gmail.com>
Date: Tue, Jan 28, 2014 at 5:06 PM
Subject: Your article on The Conversation referring to vaccination / immunisation

Professor Hamilton, re your article “Climate and vaccine deniers are the same: beyond persuasion”, published on The Conversation today, and your comment: “Scientifically there is no debate about immunisation, with every relevant health authority strongly endorsing vaccination.”

Are you aware that ‘vaccination’ and ‘immunisation’ are not the same?

Are you suggesting that citizens are not entitled to challenge ‘health authorities’ on the implementation of individual vaccine products of questionable value, e.g. human papillomavirus (HPV) vaccines? 

On the subject of HPV vaccination, (which is currently implemented for boys and girls 10-15 years in Australia)[1], the Gardasil HPV vaccine was originally rejected by the Australian Pharmaceutical Benefits Advisory Committee (PBAC) in 2006.  

An article published in The Australian newspaper at the time, “Howard rescues Gardasil from Abbott poison pill”, reports the PBAC rejected Gardasil because it was “too expensive and, just maybe, not what it was cracked up to be anyway”.  According to the article, Tony Abbott, then the Australian Federal Health Minister “took to the airwaves, passing on PBAC’s concerns about the efficacy of Gardasil and even floating the bizarre idea that a misplaced confidence in the effectiveness of the vaccine might actually result in “an increase in cancer rates”.”[2]

According to Matthew Stevens’ report in The Australian, it took just 24 hours for the then Australian Prime Minister, John Howard, to “put an end to the nonsense”, delivering “sparkling prime ministerial endorsement to Gardasil along with a clear direction to Minister Abbott that the immunisation program should proceed.  And pronto.”[3]

In her report “Government response to PBAC recommendations”, Marion Haas provides some commentary on the Australian government’s interference with the PBAC’s initial rejection of Gardasil, noting the then Prime Minister, John Howard, “intervened personally by announcing that the drug would be subsidised (ie listed) as soon as the manufacturer offered the right price.  The PBAC subsequently convened a special meeting and recommended that Gardasil be listed on the PBS”[4] (Pharmaceutical Benefits Scheme).

Haas notes the main objectives “of the PBAC are to consider the effectiveness and cost-effectiveness of medicines in making recommendations to government regarding the listing of drugs for public subsidy.  A perceived willingness to interfere in this process may undermine these objectives…”  Government reaction which results in reversal of PBAC decisions has “the potential to send signals to manufacturers and lobby groups that a decision made by the PBAC may be reversed if sufficient public and/or political pressure is able to be brought to bear on the PBAC…this may undermine the processes used by the PBAC to determine its recommendations and hence the perceived independence of the PBAC.”[5] 

Getting a vaccine on the Australian Pharmaceutical Benefits Scheme must be the ‘golden goose’ for vaccine manufacturers as this assures a mass market for their vaccine product.  Other countries have also adopted HPV vaccination, impacting on millions of children around the world and resulting in multi millions of dollars’ worth of sales for Merck (Gardasil) and GlaxoSmithKline (Cervarix)[6], and royalties for entrepreneurial scientist Ian Frazer from sales of HPV vaccines in developed countries[7], and for CSL which receives royalties from sales of Gardasil.[8].

In his article published on The Conversation in July 2012, HPV vaccine technology co-inventor Ian Frazer acknowledges that the risk of cancer associated with the HPV virus is very low, i.e. “Through sexual activity, most of us will get infected with the genital papillomaviruses that can cause cancer. Fortunately, most of us get rid of them between 12 months to five years later without even knowing we’ve had the infection. Even if the infection persists, only a few individuals accumulate enough genetic mistakes in the virus-infected cell for these to acquire the properties of cancer cells.”[9]

The National Cervical Screening Program (NCSP) website notes: “HPV infection is very common and in most people it clears up naturally in about 8-14 months…Genital HPV is so common that it could be considered a normal part of being a sexually active person.  Most people will have HPV at some time in their lives and never know it…A few of the many types of HPV have been linked with causing abnormalities of the cervix and in some cases the development of cancer of the cervix.”  The NCSP website highlights that: “It is important to remember that most women who have HPV clear the virus naturally and do not go on to develop cervical cancer.”[10]

Since the introduction of the National Cervical Screening Program, the mortality from cervical cancer has halved.[11]

Given the low risks associated with the HPV virus, the Australian government’s role in over-turning the PBAC’s original rejection of the lucrative Gardasil vaccine, and the lobbying involved, should be subjected to scrutiny.  My open letter to Chris Mitchell, Editor-in-Chief of The Australian, includes more information on this matter, ie: Is universal HPV vaccination necessary?  (8 October 2012.)

Professor Hamilton, people such as yourself, with your ill-informed and unhelpful generalised comments about the complex area of vaccination/immunisation are impeding transparency and accountability for the Australian government’s implementation of questionable vaccine products.  Given your position as a Professor of Public Ethics at Charles Sturt University, perhaps you should think more carefully before wading in on a matter on which you so obviously know little about.

Note:  I had planned to post this response on your article on The Conversation today, but I see that comments have already closed.

Sincerely

Elizabeth Hart

References:

1.     National Immunisation Program Schedule from 1 July 2013: http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/nips-ctn

2.     Howard rescues Gardasil from Abbott poison pill. The Australian, 11 November, 2006: http://www.theaustralian.com.au/archive/business/howard-rescues-gardasil-from-abbott-poison-pill/story-e6frg9lx-1111112503504

3.     Ibid.

4.     Haas, Marion. “Government response to PBAC recommendations”. Health Policy Monitor, March 2007: http://hpm.org/en/Surveys/CHERE_-_Australia/09/Government_response_to_PBAC_recommendations.html

5.     Ibid.

6.     FierceVaccines special report on the 20 Top-selling Vaccines – H1 2012 states that H1 2012 sales for Gardasil (Merck) were $608 million, and sales for Cervarix (GlaxoSmithKline) were $285 million: http://www.fiercevaccines.com/special-report/20-top-selling-vaccines/2012-09-25

7.     “Catch cancer? No thanks, I’d rather have a shot!”. The Conversation, 10 July 2012: https://theconversation.com/catch-cancer-no-thanks-id-rather-have-a-shot-7568  The disclosure statement on this article by Ian Frazer states: “Ian Frazer as co-inventor of the technology enabling the HPV vaccines receives royalties from their sale in the developed world.”

8.     CSL ups profit guidance on Gardasil sales. The Australian, 27 November 2012: http://www.theaustralian.com.au/business/companies/csl-ups-profit-guidance-on-gardasil-sales/story-fn91v9q3-1226524726672#

9.  “Catch cancer? No thanks, I’d rather have a shot!”. The Conversation, 10 July 2012: https://theconversation.com/catch-cancer-no-thanks-id-rather-have-a-shot-7568

10.     HPV (human papillomavirus), National Cervical Screening Program, Australian Government Department of Health and Ageing: http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/hpv

11.  Key Statistics. National Cervical Screening Program: http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/facts